...Medicare pay discounted prices, but don’t have enough leverage to bring fees down anywhere close to actual costs...

I stopped reading at this point. I know the article is talking about hospitals in particular, however, they more than make up for this in dealing with physicians. I get paid, on average, 15 cents on the dollar by Medicare/Medicaid when compared to private pay/insurance companies.

I would also submit that this probably more than makes up for any "loss" in dealing with hospital rooms, etc.